Finance, Health, Insurance broker

Finding the Right Health Insurance Plan for You

Through the ObamaCare marketplace, there are four kinds of health insurance plans: Bronze, Silver, Gold and Platinum. Sometimes referred to as the “metal plans,” these plans represent four tiers of coverage. metal-plansAside from these, people with hardship exceptions and those under 30 can also take advantage of specially designed health plans through the marketplace. These often come with a low premium but high out-of-pocket costs. If you are looking to buy health insurance under ObamaCare, you can do that directly with an approved provider or though a broker of health insurance that can help you compare plans of several providers before making a decision. Let’s take a closer look at these four tiers available through the marketplace.

Bronze Plans

Bronze Plans has the insurance provider pay for only 60% of the health care expenses, and the policy holder is responsible for the remaining 40%. This plan includes the most basic services and includes a limited amount of network providers. Most low-income Americans can quality for very low-cost Bronze Plans, but your actual out-of-pocket expenses has to be considered before deciding on this plan.

Silver Plans

Silver Plans are known as the “marketplace standard,” and will cap the premiums. This plan on the marketplace cannot cost over 9.5% of your income if you earn less than four times the poverty level for your family size. A premium cap is established based upon household income levels. A silver plan is great for individuals and families who are generally healthy and limit visits to providers to routine visits and the occasional emergency.


Gold Plans

They might cost a little more, but Gold Plans offer lower deductibles and splits the coverage costs with the provider 80/20. This plan is generally for families that are not overly concerned with actual health care costs or from getting the kind of care they feel they deserve. The gold plan is designed for families that may use doctors and hospitals more than the average American or have an individual that may have a chronic illness that requires more attention, tests and procedures than the average family household.

Platinum Plans

Platinum Plans have the highest monthly premiums and come with the lower out-of-pocket costs. If you or your family members require the best healthcare coverage, utilize costly services or have dependents that are stricken with regular visits to doctors and hospitals, this is the plan for you. The coverage split between you and the provider is 90/10 but you can negotiate a premium cap with the provider.

Catastrophic Coverage


Catastrophic coverage is limited to select groups that meet certain criteria. Hardship cases, young adults under 30 and those persons that fall below established income levels. You will have a higher than average deductibles and your out-of-pocket costs will be higher that most people. This low cost health insurance plan will protect you only during worst case scenarios and will make sure that you do not pay the shared responsibility fee for not having health coverage.

Selecting a new healthcare plan in 2014 and beyond does require you to have a basic understanding of these five levels of the new affordable care act and to make a few assumptions about how you may use healthcare services in the months and years to come. Your current income level will be used to calculate premium caps for each level. Using a health insurance broker that is educated on these plan tiers and has good experience getting low cost health insurance for his clients will be invaluable. There are several independent health insurance agents in Philadelphia that can help you navigate the marketplace options. They will often ask you to start with setting up an account at but then consult with them before comparing options.

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